Manhattan Breast Lift, The Ideal Solution to Sagging
A woman’s breasts can begin to sag for any number of reasons, ranging from pregnancy and breast-feeding to the simple passage of time. This is well-understood by most people, and certainly by any woman who has witnessed a change in the projection of her breasts. What may not be apparent to most people is that there are different types of breast sagging (clinically referred to as breast ptosis), and that developing a truly effective treatment plan that meets the unique needs of the individual requires an intimate knowledge of these different types. This surgical approach to a breast lift is unique to Dr. Robert Freund and why so many of his patients are extremely pleased with their results for years on end.
If you are dissatisfied with the appearance of your breasts due to sagging, Dr. Freund offers a range of solutions. For further information about breast lift surgery, please contact our New York office today.
Types of Breast Sagging
Ideally, a woman’s nipple and areola should be located above the inframammary fold, the point at which the underside of the breast meets the chest. There are four classifications of sagging based on this standard:
- Type I: the areola is located at the same level as the inframammary fold
- Type II: the areola falls below the inframammary fold
- Type III: the areola falls below the inframammary fold, and the nipple points downward
- Pseudoptosis: the areola is located above the inframammary fold, but the breast tissue beneath the areola sags below the fold
The most effective technique for performing breast lift surgery depends entirely on the type of sagging that a woman is experiencing.
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Breast Lift Techniques
The various techniques used to perform breast lift surgery are similar to those used to perform breast reduction. The endgame of breast lift, however, is to elevate the projection of the breasts on the chest, without affecting volume. An important concept is that if you want to change the volume of the breast, then change the volume. However, never use volume changes to improve the shape of a sagging breast. Many patients and physicians feel that augmenting a sagging breast will lift it as well. In my experience, this maneuver just leaves a larger sagging breast.
Dr. Freund generally uses one of three technique, depending on the case, to perform a breast lift.
The Teardrop Augmentation Mastopexy Technique
The Teardrop Augmentation Mastopexy technique is a technique to lift and augment the breast (i.e. add volume with an implant) by lifting the breast tissue under the skin while naturally augmenting the volume with minimal removal of the skin around the areola (commonly known as a “donut incision”). Dr. Robert Freund pioneered this technique and has presented his unique breast lift technique to many plastic surgery and aesthetic medical symposiums over the years. You may have heard of the term “donut incision” when reading about other circumareolar incision breast lift techniques, but the Tear Drop Augmentation Mastopexy is very different.
Most plastic surgeons perform a breast lift by creating an incision around the areola, removing excess skin, and then lifting and tightening the breast into a more youthful position. These techniques may temporarily raise the breast, but will result in a wide, flat breast with wide scars. These undesirable results are caused because the removal of the skin and tightening of the breast is the primary force behind the lift. When a patient combines a traditional breast lift with an implant, it’s synonymous to re-inflating a balloon.
The Teardrop Augmentation Mastopexy technique is different in that it physically lifts the breast tissue from underneath the skin and secures it to the upper chest wall. A minimal amount of skin is removed, but unlike a traditional breast lift, the excision of the skin is not the force behind the lift. The breasts are still lifted into a more youthful position, but because there is minimal skin excision, there is less tension on the incision resulting in less scarring, less flattening of the breasts, and less loss of natural breast volume. And because there is less loss of natural breast volume with the Teardrop Augmentation Mastopexy technique, patients achieve greater projection and volume when the breast implant is added.
The Göes Technique
For most women suffering from type I and type II sagging, Dr. Freund uses the Göes technique to perform breast lift. Through an oval-shaped incision that extends from the base of the areola to just above, he raises and sculpts the breast tissue into an aesthetically appealing new shape and then sutures it into position against the chest wall. This new shape is secured with an internal brassiere to ensure durability. The nipple is elevated to the top of the oval, leaving a scar that discreetly blends into the border of the areola. This subtle scar, along with the natural-looking results possible through this method, makes the Göes technique preferable whenever appropriate to the case.
The Lejour Technique
The Lejour technique is well-suited to women who are experiencing type III sagging and pseudoptosis, as well as to those who have type II sagging but wish to have fuller, more youthful looking breasts than are possible with the Göes technique. Dr. Freund makes an incision around the areola and a second incision that extends in a straight line from the base of the areola to the bottom of the breast, in essence creating a lollipop-shaped incision. Through this incision, the breast tissue is raised, sculpted, and stitched to the chest wall, after which the nipple is raised and the surrounding skin is brought together and sutured shut. While the Lejour technique leaves an additional, albeit discreet, scar as compared to the Göes technique, it also improves the projection of the breast to the point that it looks fuller and larger. In many cases, correcting sagging through the Lejour technique produces results that many women thought possible only through the placement of breast implants.
Can Breast Implants Correct Sagging?
In some cases, women with smaller breasts and minor sagging may achieve satisfactory results through the placement of a breast implant, but this is rare. In most cases, adding breast implants to saggy breasts will simply result in bigger sagging breasts. In general, breast augmentation with implants should be reserved for women who wish only to add volume to their breasts, while those who wish to correct sagging are most often best served by breast lift surgery.
This is not to suggest, however, that combining breast lift and breast augmentation as part of a well-thought-out, comprehensive treatment plan is necessarily a bad idea. In the hands of the right surgeon, subtle increases in volume through the insertion of implants during breast lift surgery can lead to durable, natural-looking results. Such is the case with teardrop augmentation mastopexy, a method of combining breast lift and breast augmentation pioneered by Dr. Freund.
Teardrop augmentation mastopexy combines a variation on the Göes technique with the placement of a round saline breast implant beneath the chest muscle. This combination results in a teardrop-shaped breast with outstanding projection. Because Dr. Freund expertly reshapes and repositions the existing breast tissue, lifting it into the hollow portion of the upper chest, a relatively small implant is all that is needed to enhance the results. The results are remarkably beautiful and natural looking.
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